1978, 03-17 Permit App: M5297 Addition•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 7 9—
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or st
kind or alter any building or structure already erected, or to change a land use. Construction must co
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water supply must be approved by the County and State Health Departments. Where work on water connec
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions• Nos. 45-133 and 47.235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front prope
least 25' is required, a 5' side yard, 15' side yard from a flanking stteety and a 25' rear -yard are requ'
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -ba
and egress. _
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department an
performed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a C
Highway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running
which are enforceable through civil action. County Officials can not bring action to enforce covenants or
APPLICANT FILL IN BELOW THIS LINE
..:.rte
Name of Owner .•/ r .ai. Address 3Phone
Architect Address Phone
Engineer Address Phone
Contractor - Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number n 9542- 4
ucture of any
form with the
ions disturbs
Office.
y line, of at
ed.
k and ingress
work must be
unty or State
with the land
dedications.
S 7
Lair 4 /3 Lh'
ROADWAY R/W WIDTH
DESCRIPTION OF WORK: New
Size of Lot in X/Ain/
r
Stories 1 Dimensions 2*X 44i
Addition_ Remodel Moving Bldg. Zone 1 Fire
Sewage System Ad A (Fr.• CConConst.
Total Sq Ft 6 zii Valuation
ce n� -f- Chimney (Kind)
Heat
Firepla
Heat. SystemfXa-e BBB Type of Virg Ext Finishn/ Int Wall Finish
'Use�Bldg. f, ,°141.7//P OAp,I7`,jiU No of Units _ Bedroo
-k - PLOT PLAN
Rooms .._ Baths /44 Basement ai A-
(Full, part, none)
Foundation Const
e,3
S -RM LQ
., Br., etc.l)-
J-O oO
/E
N pbe
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location o
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location
tem and water supply lines.
0
GRACE AJC
NORTH
Qet P11
I he eby
as shows
SOUTH
=ion submitted
is correct and
m
In
N
N
s
existing and
f sewage sys-
State License
No.
Ind. Ins. Acct.
No.
RESIDENTIA - C
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
MMERCIAL
there are no other structures located on this
3 —17— 7,g
operty except
Owner orciaent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION CO
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
be e . /i 2 9d-az#
;our street address will
' Sewage Permit Number
•Remarks
0.
Issued
MENCES.
- - 3 The zone isL
Building Permit'V ' Receipt t&99 Issue
f n -„r -d— OJT
Form 523 Bldg. Code